Provider Demographics
NPI:1174027767
Name:SOLICE, HALEIGH BROOKE (LVN)
Entity Type:Individual
Prefix:
First Name:HALEIGH
Middle Name:BROOKE
Last Name:SOLICE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11849 STATE HIGHWAY 7 W
Mailing Address - Street 2:
Mailing Address - City:CENTER
Mailing Address - State:TX
Mailing Address - Zip Code:75935-7824
Mailing Address - Country:US
Mailing Address - Phone:936-229-8815
Mailing Address - Fax:
Practice Address - Street 1:11849 STATE HIGHWAY 7 W
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935-7824
Practice Address - Country:US
Practice Address - Phone:936-229-8815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX342090164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse